"When fascism comes to America, it will be wrapped in the flag and carrying the cross."
-- Sinclair Lewis

Wednesday, June 14, 2017

Is Medicare-For-All A Litmus Test For Supporting A Candidate For Congress?

>

Tulchin Research has long been best known as the Blue Dog polling firm. There aren't that many Blue Dogs left-- despite strenuous efforts by the DCCC-- and they've had to branch out and find clients among (slightly) less odious corporate Dems, like Gavin Newsom and Julia Brownley. Earlier in the week, the firm's two principals, Bens Tulchin and Krompak, penned an OpEd for the Sacramento Bee, Universal health care is the new litmus test for Democrats. Their perspective is more in line with normal California grassroots Democrats than with their own client, Richard Pan (of Sacramento), who was one of only 4 Senate Dems who refused to vote for Ricardo Lara's and Toni Atkins' Healthy California Act (S.B. 562-- Medicare-for-All). It passed the Senate without Pan's help.The 2 Bens seem to be making a logical and compelling case for a wildly popular idea-- single payer universal healthcare-- that the clients they've been helping to elect for many years generally oppose.

Following California’s lead, Democrats nationally are embracing plans to expand Medicare to provide all Americans with health insurance. The trend is substantive and strategic, as the party seeks remedies to the country’s health care challenges, and looks to rebuild its base with working class voters facing rising health care costs.As pollsters, we see the disconnect between what Americans want and the policies Washington is pursuing.Our polling finds health care to be a top concern, with voters clearly disapproving of the Republicans’ American Health Care Act. Others confirm what we have found.A new Kaiser Family Foundation poll finds just 8 percent of Americans want the U.S. Senate to pass the House Republicans’ version of health care. It’s easy to see why.Trump pledged an Obamacare replacement that would cover everyone, reduce health care costs, and improve care. The House Republican bill does just the opposite, giving the rich hundreds of billions of dollars in tax cuts, stripping health insurance from 23 million people and raising costs for many others.As a Senate Republican majority awash in campaign contributions from insurance and pharmaceutical companies debates what to do with this deeply unpopular bill, elected Democrats are warming to the voters’ will.A recent Economist/YouGov poll finds 60 percent of adults favor “expanding Medicare to provide health insurance to every American.”In California, our polling finds even stronger support. Medicare for All is favored by 70 percent of the state’s voters, including 53 percent of Republicans, 72 percent of independents, and 79 percent of Democrats.While Democratic grassroots enthusiasm for universal health care is unsurprising, the growth in support among Democratic elected officials is truly remarkable.Many in the party establishment last year dismissed single-payer. In January 2016, Hillary Clinton declared Medicare for All an idea “that will never, ever come to pass.”Today, with the California Senate passing a Medicare for All bill and states such as New York considering it, support for Medicare for All legislation championed for 15 years by Rep. John Conyers, D-Mich., has grown from 25 sponsors in 2003 to 111, a majority of House Democrats.In the Senate, single-payer champion Bernie Sanders, who made Medicare for All a centerpiece of his surprisingly strong 2016 presidential campaign, has emerged as the leading Democratic voice on health care. He proposed reforms to lay the foundation for universal coverage, including lowering the Medicare eligibility age and allowing Medicare to negotiate drug prices with pharmaceutical companies.Single-payer has not yet been endorsed by the Democratic leadership in Congress. But growing grassroots and political support for Medicare for All soon could make it the de facto Democratic health care plan, with or without the leaders.Progressive organizations such as the California Nurses Association are making the issue a priority for 2018. Candidates competing in Democratic primaries will have to consider this dynamic.Victor Hugo wrote that one cannot resist an idea whose time has come. Medicare for All soon could become the new litmus test for Democratic candidates, including those who are running for governor in 2018 and for the presidency in 2020.

And for members of Congress. I know that at Blue America, when we interview candidates and they say they oppose single payer, it makes it almost impossible for them to earn an endorsement. Almost. Let's take a look at the letter Beto O'Rourke sent his supporters in Texas this week. (He's the congressman from El Paso who's running for the Texas U.S. Senate seat currently occupied by anti-health care fanatic Ted Cruz.) We were among many of his supporters who have asked him why he hasn't signed on as a co-sponsor of John Conyers' Medicare-For-All bill. Beto began his explanation with an acknowledgment: "We need a single-payer healthcare system for all Americans. It's the only way to ensure that everyone who needs to see a doctor is able to see a doctor-- preventatively, consistently and with real continuity of care. If we wait until someone is in crisis or shows up at the Emergency Room to take care of them, it's going to be worse for them and more expensive for the taxpayer."

How do we ensure that everyone in this country can see a medical provider when they need to and at the same time drive down total medical spending? How do you ensure that doctors, nurses, psychiatrists and psychologists are focused on their patients and not spending their time working for the insurance companies? How do we free up the economic and creative potential that could be unleashed if healthcare were not a function of wealth, employment or luck?The only way I can figure out how to get all of that done is to have one system that covers every American and works with every hospital, clinic, and doctor's practice-- private, public or non-profit-- in the country.I like Medicare. It's not perfect, but the satisfaction rates are high, the administrative costs are low, and it may be the single most successful healthcare program in our country.There's a bill called "Medicare for All" (HR 676) that has gained a lot of support for these very reasons. Like the woman who spoke with me in Austin this weekend, many of you have written to me to ask why I have not signed on.The way it's written, HR 676 would only provide Medicare reimbursements to non-profit providers. In other words, unlike Medicare-- which reimburses care at both for-profit and not-for-profit providers-- HR 676 would fundamentally change Medicare, limiting the pool of potential providers, and therefore the choice available to Americans when seeking healthcare.
I've asked the author of HR 676 to change the bill and have it do exactly what Medicare does: reimburse medical providers, regardless of whether they work at a not-for-profit or for-profit institution. If Medicare works for current beneficiaries, why would we change it when we open it up to all Americans?I am exploring an alternative to the Medicare for All bill that would allow Medicare to work for everybody the way it does right now for Americans ages 65 and over. I'm hopeful that this will provide a path for members of Congress who want to make sure that we do the right thing in a way that has the best chance for success and the greatest level of support across the political spectrum.What we invest in our nation's healthcare system, we're going to get back many times over in the productivity of the American citizen, in the health of our communities and the success we see in our families. Those are our values -- and those values transcend party lines. Those values are family values. Those values are Texas values. And that's what we must continue to fight for.

An idea whose time has come. I like that. California can lead the way.

From what I have read, however, I disagree with California's push to make everything free and fund it all just thru taxes. To me, this is an absurd way to initiate this huge undertaking. Low costs would do just fine - low copays, low office visit fees - completely free is a very bad idea. There is nothing wrong with people paying something for each service. Health care is far too expensive to be absolutely free - not a reasonable nor appropriate idea. I don to think anyone would expect to never pay anything for lots of their health care.

When I started a private practice in psychology, I was advised never to give sessions for free, always charge the client even if a modest cost, like $10. People take "free" far too much for granted and have little investment in the whole process. Of course therapy is different from medical service, but the idea still holds.

Three thoughts:

First, people have a responsibility to pay something for what they get.

Second, it is unfair to put the entire burden for the costs on taxes. Some people would be paying a lot while others get it all for free? Unfair. Everyone should pay something for services. Medicare is not free. People pay for it. The minimum cost is $109 a month. I think most Americans would be thrilled to pay that little. Services and drugs are at a modest cost, not free. There is absolutely nothing wrong with setting modest costs.

Third, this is a gigantic and extremely costly undertaking. To start out from the get-go with it free, the whole plan might collapse. People should be charged something to contribute to covering the costs. The costs could always be lowered over time if the plan succeeds and is cost effective.

Hone makes good points. This CA resident would accept them as a reasonable brake on people abusing the system with relatively minor complaints, something which can clog ERs when nothing else is open. Adjustments can be made later when performance and costs of the plan can be evaluated.

Addressing the original point of the litmus test for candidates, there are times that no other option works. There are certain things which are either-or, yes-no. A candidate is either for something or against it and there is no middle ground, so a litmus test cuts to the chase and eliminates a lot of pointless blather. Any candidate who can't take a stand deserves to be defeated, so there is no maybe involved.

This is the health care insurance equivalent to the non-existent, and quintessentially fraudulent, "voter fraud" campaign. It reeks of a "they LIKE to be sick" variant of the general and pernicious "they LIKE to be poor" meme cynically used to justify and perpetuate the reasons and mechanisms that produce poverty.

THE major abuse in the current health care complex is committed by those*** in control of the system NOT those it purports to serve: insurance companies, for-profit hospitals, anti-Hippocratic Dr's etc. ... all the usual suspects, just in a different industry, diverting blame onto those against whom they are committing financial and professional fraud.

As I understand, the CA system is be funded by an increase in payroll tax. Therefore, the only sub-set that would not "pay something" would be the unemployed. Why should they be further abused by insisting they need to produce cash for medical care when they are already suffering the ultimate abuse of the lies of the general system?

Sometimes this site seems to be more of a suppression of progressive thought (Scarborough, Frum, Coulter, Kristol, etc., ... etc., not to mention sanctimonious comments from those lucky enough to not yet be shunted into the "outlet" tube of the pulverizing economic system) than a promulgator of progressive thought that it alleges to be.

---

*** see, for example, current governor of Florida, unindicted mastermind, and benefactor, of the record largest Medicare fraud scheme.

I applaud CA for moving on this. I wish them luck. If it passes and works, it'll expose most of their DC democrap contingent (Pelosi, Feinstein...) as the massive corporate whores they are and maybe they could be replaced.

But you'd need to replace 190 of the DC dems in the house and replace 40 of the Rs with good people, not democraps hand-picked by Pelosi's corporate donors.

Who's been saying this forever? Seems I've seen this before. Whatever.

I don't agree about out-of-pocket augmenting the tax. Health care needs to be elevated to a basic right. In fact it needs to be our first (and now, only remaining) right as citizens. NOBODY should be faced with a decision between spending even their last $10 on food or on a doc visit to see what's up with that lump. It needs to be a combination of payroll and corporate taxes and maybe even increases in sin-taxes. Insurance companies need to go away entirely; rates need to be negotiated with providers and fraud must be enthusiastically prosecuted; and PHRMA prices need to be negotiated and/or dictated. You cannot have Rx prices sky-rocketing to make PHRMA CEOs wealthy. And reimportation needs to be legalized, which will also pressure prices downward.

But none of this matters if the political process is still a matter of begging/whoring for money from corporations and wealthy sociopaths. We've seen repeatedly that even good lege gets ratfucked as soon as enough money is applied, reps are bought and that good lege gets repealed.